DESCRIPTION: A family history of breast cancer is the single best predictor of a health woman's risk of developing the disease. The long term objective of the proposed research is to investigate two possible pathways by which stress associated with this familial threat of breast cancer could further increase the health risks of these women: 1) Psychological factors (e.g., distress) may influence biological processes that play important roles in health and disease; 2) Fear and distress about breast cancer may influence women's decisions to engage in screening behaviors (e.g., mammography) that permit early detection and increase the likelihood of curative treatment. In addition, the project seeks to investigate the possibility that the consequences of stress associated with having a positive family history may be stronger in African American women, for whom the fear of developing breast cancer may be especially high. The proposed project has three aims. The first is to investigate the lasting psychological, biological, and behavioral consequences of having a family history of breast cancer. A naturalistic longitudinal study is proposed, in which 100 health women with family histories of breast cancer (Risk Group) and 100 with no cancer in first degree relatives (Comparison Group) will be assessed on three separate days approximately a month apart. Half of the women in each group will be African American and half will be white. Specific Aim 2 is to examine psychological and biological reactions to exposure to cues associated with the threat of breast cancer. An experimental study is proposed, in which 80 health women from each of the Groups in Study One will undergo assessments of psychological, cardiovascular, neuroendocrine, and immune variables before and after exposure to breast-cancer specific cues. Again, half of the women in each Group will be African American and half white. Specific Aim 3 is to explore the impact of women's negative emotional reactions to the threat of breast cancer screening guidelines. The data from the naturalistic and experimental studies will be combined to investigate the possibility that strong stress reactions to the threat of cancer may inhibit breast cancer screening behaviors.